Evidence in peroneal nerve entrapment: A scoping review

peer reviewedBackground and purpose: Daily management of patients with foot drop due to peroneal nerve entrapment varies between a purely conservative treatment and early surgery, with no high-quality evidence to guide current practice. Electrodiagnostic (EDX) prognostic features and the value of imaging in establishing and supplementing the diagnosis have not been clearly established. Methods: We performed a literature search in the online databases MEDLINE, Embase, and the Cochrane Library. Of the 42 unique articles meeting the eligibility criteria, 10 discussed diagnostic performance of imaging, 11 reported EDX limits for abnormal values and/or the value of EDX in prognostication, and 26 focused on treatment outcome. Results: Studies report high sensitivity and specificity of both ultrasound (varying respectively from 47.1% to 91% and from 53% to 100%) and magnetic resonance imaging (MRI; varying respectively from 31% to 100% and from 73% to 100%). One comparative trial favoured ultrasound over MRI. Variable criteria for a conduction block (>20%–≥50) were reported. A motor conduction block and any baseline compound motor action potential response were identified as predictors of good outcome. Based predominantly on case series, the percentage of patients with good outcome ranged 0%–100% after conservative treatment and 40%−100% after neurolysis. No study compared both treatments. Conclusions: Ultrasound and MRI have good accuracy, and introducing imaging in the standard diagnostic workup should be considered. Further research should focus on the role of EDX in prognostication. No recommendation on the optimal treatment strategy of peroneal nerve entrapment can be made, warranting future randomized controlled trials. © 2021 European Academy of Neurolog

How to Choose the Right Inhaler Using a Patient-Centric Approach?

There are many different inhaler devices and medications on the market for the treatment of asthma and chronic obstructive pulmonary disease, with over 230 drug-delivery system combinations available. However, despite the abundance of effective treatment options, the achieved disease control in clinical practice often remains unsatisfactory. In this context, a key determining factor is the match or mismatch of an inhalation device with the characteristics or needs of an individual patient. Indeed, to date, no ideal device exists that fits all patients, and a personalized approach needs to be considered. Several useful choice-guiding algorithms have been developed in the recent years to improve inhaler-patient matching, but a comprehensive tool that translates the multifactorial complexity of inhalation therapy into a user-friendly algorithm is still lacking. To address this, a multidisciplinary expert panel has developed an evidence-based practical treatment tool that allows a straightforward way of choosing the right inhaler for each patient

Study protocol of KLIMOP: a cohort study on the wellbeing of older cancer patients in Belgium and the Netherlands

<p>Abstract</p> <p>Background</p> <p>Cancer is mainly a disease of older patients. In older cancer patients, additional endpoints such as quality of survival and daily functioning might be considered equally relevant as overall or disease free survival. However, these factors have been understudied using prospective designs focussing on older cancer patients. Therefore, this study will focus on the impact of cancer, ageing, and their interaction on the long-term wellbeing of older cancer patients.</p> <p>Methods/Design</p> <p>This study is an observational cohort study. We aim to recruit 720 cancer patients above 70 years with a new diagnosis of breast, prostate, lung or gastrointestinal cancer and two control groups: one control group of 720 patients above 70 years without a previous diagnosis of cancer and one control group of 720 cancer patients between 50 - 69 years newly diagnosed with breast, prostate, lung or gastrointestinal cancer. Data collection will take place at inclusion, after six months, after one year and every subsequent year until death or end of the study. Data will be collected through personal interviews (consisting of socio-demographic information, general health information, a comprehensive geriatric assessment, quality of life, health locus of control and a loneliness scale), a handgrip test, assessment of medical records, two buccal swabs and a blood sample from cancer patients (at baseline). As an annex study, caregivers of the participants will be recruited as well. Data collection for caregivers will consist of a self-administered questionnaire examining depression, coping, and burden.</p> <p>Discussion</p> <p>This extensive data collection will increase insight on how wellbeing of older cancer patients is affected by cancer (diagnosis and treatment), ageing, and their interaction. Results may provide new insights, which might contribute to the improvement of care for older cancer patients.</p

Comparison and Evaluation of Osiris and Sirscan 2000 Antimicrobial Susceptibility Systems in the Clinical Microbiology Laboratory

The Osiris and Sirscan 2000 systems are two semiautomated systems that can be used to read and interpret the results on disk diffusion agar plates. They are both used for determination of susceptibility to antimicrobial agents. The present study compared both systems versus the NCCLS standard method of visual reading with a ruler. Both inpatient and outpatient samples with a total of 315 nonfastidious gram-negative strains were obtained. In total, 3,724 organism-antimicrobial agent combinations that fulfilled the NCCLS guidelines for disk diffusion susceptibility testing were evaluated prospectively. The results obtained with both systems in comparison with those obtained by the classical nonautomated means of interpretation were excellent, with correlation coefficients of 0.96 for both systems. The overall agreements for susceptibility interpretation were 96.56 and 96.24% with the Osiris and Sirscan systems, respectively. Very major errors were obtained for 8 (1.07%) and 10 (1.34%) organism-antimicrobial agent combinations with the Osiris and Sirscan systems, respectively. In addition, major errors were obtained for 2 (0.07%) and 6 (0.21%) combinations with the Osiris and Sirscan systems, respectively. Minor errors were obtained for 118 and 124 organism-antimicrobial agent combinations with the Osiris and Sirscan systems, respectively. Overall, both the Osiris system and the Sirscan system are comparable and reliable systems for determination of interpretative categories from the zone diameters of standard disk diffusion test plates

Tien jaar kanker in de provincie Limburg (1996-2005): de belangrijkste individuele lokalisaties

In het vorige artikel over tien jaar kankerregistratie in Limburg werd gerapporteerd over de methodiek vanhet Limburgs kankerregister (Likar)en over de incidentie, tijdstrends en voorspellingen van alle kankers samen. In dit artikel worden meer in detail borstkanker, prostaatkanker, longkanker, gastro-intestinale kankers, blaaskanker, melanomen en andere huidkankers, kankers van uterus, ovaria en cervix, en hematoligsche kankers belicht.status: publishe